应用吸割器治疗放疗后后鼻孔闭锁10例

目的 探讨吸割器治疗鼻咽癌放疗后后鼻孔闭锁的效果。方法 10例鼻咽癌放疗后后鼻孔闭锁患者采用鼻内窥镜下吸割器后鼻孔闭锁成形术，对照手术前后的治疗效果。结果 全部病例鼻塞和张口呼吸全部消失，随访1年无复发。结论 吸割器治疗鼻咽癌放疗后后鼻孔闭锁是一种安全有效的手术方法。     

后鼻孔闭锁手术治疗体会

目的 探讨后鼻孔闭锁的手术时机和手术方式.方法 对7例后鼻孔闭锁病例的临床资料进行回顾性分析.结果 7例患者中经腭手术1例,经鼻在鼻内窥镜下利用电动吸切器完成手术6例,随访3年后鼻孔无狭窄.结论 根据闭锁组织的类型选择合适的手术方法,术中置管扩张、术后加强护理及定期随访是保证手术成功的关键.     

鼻内窥镜微波治疗放疗性后鼻孔闭锁临床分析

目的 研究观察鼻内窥镜微波治疗放疗性后鼻孔闭锁的临床效果.方法 选取我院于2011年1月至2011年5月收治的44例放疗性后鼻孔闭锁患者的临床资料,所有患者均采用鼻内窥镜微波治疗.结果 所有患者均经一次切除手术,4个月痊愈.44例患者随访发现3例患者通气不畅,1例患者发生再次粘连.本次手术治疗后与治疗前患者症状改善显著,差异具有统计学意义(P<0.01).结论 鼻内窥镜微波治疗放疗性后鼻孔闭锁视野清晰、对组织上的损伤较小,可以缓解患者的疼痛,且远期效果满意,值得推广.     

鼻咽癌放疗术后随访结果分析

目的观察分析鼻咽癌放疗进入随访期后的并发症发生情况。方法运用CT、鼻内窥镜等检查方法对125例鼻咽癌患者进行随访观察。结果入选患者随访期发生慢性化脓性鼻窦炎102例;鼻腔粘连68例,其中后鼻孔闭锁8例,萎缩性鼻炎8例,鼻腔大出血3例。结论鼻咽癌放疗术后患者进入随访期后,其发生鼻部并发症得发生率很高,如何减少随访期并发症,提高随访期患者的生存质量,应给于足够的重视。     

鼻内窥镜手术扩大应用25例报告

我科于 1988年开展鼻内窥镜检查 ,1993年后鼻内窥镜手术器械逐步配套完善 ,升级换代 ,迄今已完成逾千例次的鼻内窥镜诊查及手术操作。此间除用于诊断鼻腔鼻窦疾病 ,治疗慢性鼻炎、鼻窦炎等疾病外 ,还将该技术加以扩大应用 ,治疗鼻咽癌 (NPC)放射治疗致后鼻孔狭窄或闭锁等疾病 2 5例 ,获良好效果 ,现报告如下。1　一般资料本文收集自 1993年以来将鼻内窥镜技术扩大应用的有关病例共 2 5例。男性 13例 ,女性 12例 ;年龄 19～ 6 5岁 ,平均46岁。鼻咽癌放射治疗致后鼻孔狭窄或闭锁者 4例 ,鼻腔或鼻窦良性占位性病变 6例 (其中鼻腔纤维血管瘤、…     

1例先天性后鼻孔闭锁并鼻中隔偏曲护理

后鼻孔闭锁为一少见疾病，主要症状是鼻塞和嗅觉障碍，如果为双侧先天性闭锁出生即有严贡的呼吸困难、紫绀、甚至窒息。在阏锁的后鼻孔造口是本病唯一的治疗方法，目的是重新建立足够的鼻呼吸通道．传统上有4种手术方法：经鼻、经腭、经鼻中隔和经上颌窦四种途径。我科于2005年7月收治1例先天性右侧后鼻孔闭锁并鼻中隔偏曲患者。采用鼻内窥镜下右侧后鼻孔成形术加鼻中隔矫正术，取得满意效果。鼻腔通气良好，嗅觉改善。现报道如下：     

鼻内窥镜下电动切吸器与微波联合应用治疗鼻腔血管瘤

目的探讨鼻内窥镜下电动切吸器结合微波治疗鼻腔血管瘤的临床效果。方法鼻内窥镜下应用电动切吸器对12例鼻腔血管瘤患者行手术摘除血管瘤，并对其残体及基底部行微波热凝。结果12例均一次成功摘除血管瘤，术中出血少，无并发症发生，随访0．5～2年无复发。结论鼻内窥镜下应用电动切吸器结合微波治疗鼻腔血管瘤，是临床应用的较好方法。     

鼻窥镜下经口切吸术治疗腺样体肥大临床分析

目的探讨鼻窥镜下经口切吸术治疗儿童腺样体肥大的疗效。方法对146例腺样体肥大患儿在全麻鼻内窥镜下经口行肥大腺样体组织切吸手术。结果总有效率100％，术后随访6月～1年，无任何并发症发生。结论鼻内窥镜下经口切割吸除腺样体组织视野清晰，范围精确，安全可靠，效果满意，是治疗腺样体肥大的理想手术方法。     

鼻咽癌放疗后慢性鼻-鼻窦炎患者的鼻内镜手术治疗疗效探讨

目的探讨鼻咽癌放疗后慢性鼻-鼻窦炎患者的鼻内镜手术治疗疗效。方法分析我院2008年1月至2013年2月五官科收治的鼻咽癌放疗后慢性鼻-鼻窦炎患者72例临床资料,观察鼻内镜治疗后3、6个月的临床疗效情况。结果鼻咽癌放疗后慢性鼻-鼻窦炎患者疗后3、6个月总有效率和生活质量评分无明显差异,P>0.05。结论鼻咽癌放疗后慢性鼻-鼻窦炎患者的鼻内镜手术治疗效果稳定,值得临床推广应用。     

显微镜辅助下鼻内窥镜经蝶窦入路垂体瘤切除术治疗分析

目的探讨鼻内窥镜技术和手术显微镜结合经单鼻孔经蝶入路切除垂体瘤的临床应用及手术技巧。方法对25例经CT扫描和MRI检查以及内分泌检查确诊为垂体瘤患者在神经内镜下经单鼻孔打开鞍底,显微镜下切除垂体瘤。结果全切21例,近全切4例。术后23例出现一过性尿崩,经药物治疗后好转。术后19例术前血清泌乳素,血清生长激素水平异常的患者术后恢复正常。20例视力好转,无严重并发症发生。结论显微镜辅助鼻内窥镜单鼻孔经蝶入路的术式能良好地显示鞍区等结构,手术创伤小、并发症少、患者恢复快。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.